Evidence map›Paper›PMID 38909255›Full record

ArticleMalaria journal2024

An epidemiological analysis of severe imported malaria infections in Sri Lanka, after malaria elimination.

Shilanthi Seneviratne, Deepika Fernando, Rajitha Wickremasinghe, Sujai Senarathne, Pubudu Chulasiri, Nethmini Thenuwara, Champa Aluthweera, Iromi Mohotti, Shamila Jayakuru, Thilan Fernando and 3 more

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Article in Malaria journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Shilanthi Seneviratne *Anti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Deepika Fernando *Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. deepika@parasit.cmb.ac.lk.
Rajitha Wickremasinghe *Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Sujai SenarathneDepartment of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Pubudu ChulasiriAnti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Nethmini ThenuwaraAnti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Champa AluthweeraAnti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Iromi MohottiRegional Malaria Office, Galle, Sri Lanka.
Shamila JayakuruAnti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Thilan FernandoAnti Malaria Campaign, Ministry of Health, Colombo, Sri Lanka.
Anula Wijesundara, Colombo, Sri Lanka.
Rohini FernandopulleFaculty of Medicine, General Sir John Kotelawala Defense University, Ratmalana, Sri Lanka.
Kamini MendisDepartment of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImported malaria continues to be reported in Sri Lanka after it was eliminated in 2012, and a few progress to life-threatening severe malaria.

methodsData on imported malaria cases reported in Sri Lanka from 2013 to 2023 were extracted from the national malaria database maintained by the Anti Malaria Campaign (AMC) of Sri Lanka. Case data of severe malaria as defined by the World Health Organization were analysed with regard to patients' general characteristics and their health-seeking behaviour, and the latter compared with that of uncomplicated malaria patients. Details of the last three cases of severe malaria in 2023 are presented.

results532 imported malaria cases were diagnosed over 11 years (2013-2023); 46 (8.6%) were severe malaria, of which 45 were Plasmodium falciparum and one Plasmodium vivax. Most severe malaria infections were acquired in Africa. All but one were males, and a majority (87%) were 26-60 years of age. They were mainly Sri Lankan nationals (82.6%). Just over half (56.5%) were treated at government hospitals. The average time between arrival of the person in Sri Lanka and onset of illness was 4 days. 29 cases of severe malaria were compared with 165 uncomplicated malaria cases reported from 2015 to 2023. On average both severe and uncomplicated malaria patients consulted a physician equally early (mean = 1 day) with 93.3% of severe malaria doing so within 3 days. However, the time from the point of consulting a physician to diagnosis of malaria was significantly longer (median 4 days) in severe malaria patients compared to uncomplicated patients (median 1 day) (p = 0.012) as was the time from onset of illness to diagnosis (p = 0.042). All severe patients recovered without sequelae except for one who died.

conclusionsThe risk of severe malaria among imported cases increases significantly beyond 5 days from the onset of symptoms. Although patients consult a physician early, malaria diagnosis tends to be delayed by physicians because it is now a rare disease. Good access to expert clinical care has maintained case fatality rates of severe malaria at par with those reported elsewhere.

Indexed as

Communicable Diseases, ImportedAdolescentAdultAgedDisease EradicationFemaleHumansMalariaMalaria, FalciparumMalaria, VivaxMaleMiddle AgedSri LankaYoung AdultDelay in diagnosisImported malariaManagementPrevention of re-establishmentSevere malariaSri LankaTravelers’ malaria

Identifiers

PMID38909255
PMCPMC11193279

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.